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Flashcards in EENT 9% Deck (81):
1

Inflammation of both eyelids =

Common in pts w/ ____.

Blepharitis

Common in Down's syndrome, Eczema

2

Painful, warm, swollen red lump on eyelid

Tx:

Hordeolum (Stye)

Tx: Warm compresses +/- topica abx (Erythromycin, Bacitracin)
I+D if no drainage after 48 hrs

3

PainLESS granuloma of internal meibomian sebaceous gland

Presentation:

Chalazion

Hard, non-tender eyelid swelling

4

Infection of lacrimal gland =

MC cause:

Tx:

Dacrocystitis

MC: S. aureus, GABHS, S. epidermis, H. flu, S. pneumo

Tx: Clindamycin + 3rd gen cephalosporin

5

Fleshy, triangular-shaped GROWING fibrovascular mass =

Pterygium

Associated w/ increased UV exposure in sunny climates

6

Yellow, elevated nodule on nasal side of eye (fat and protein) =

Pinguecula

7

Orbital floor "blowout" fracture causes diplopia especially with ___ d/t ____.

Tx:

upward gaze
inferior rectus muscle entrapment

Tx: Initial --> nasal decongestants, avoid blowing nose, prednisone
Abx (Unasyn, Clindamycin)

8

Positive Seidel's test seen in ___.

Globe rupture

= parting of fluorescein dye by clear stream of aqueous humor from anterior chamber

9

Drusen =
Seen in ___.

small, round yellow-white spots on outer retina

Dry (atrophic) macular degeneration

10

Dx of wet macular degeneration =

Flurescein angiography

11

Scotomas =
Metamorphopsia =
Micropsia =

Seen in ____

Scotomas = blind spots, shadows
Metamorphopsia = straight lines appear bent
Micropsia = object seen by affected eye looks smaller than in unaffected eye

Macular degeneration

12

Amsler Grid used for ___

management of DRY macular degeneration to monitor stability at home

13

Tx of WET macular degeneration

Anti-angiogenics (Bevacizumab)

14

What can be used to slow progression of DRY macular degeneration?

Vit A, C, E, zinc

15

Presentation of Hypertensive Retinopathy based on stage

I: Arterial narrow --> Copper wiring (moderate), Silver-wiring (severe)
II: AV nicking
III: Flame shaped hemorrhages, cotton wool spots
IV: Papilledema = malignant HTN

16

patient's pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye =

Positive in ___ (2)

Marcus Gunn

Positive in Papillitis, Retrobulbar neuritis

17

Photopsia =
Progression:

Seen in ___.

Flashing lights
--> floaters* --> unilateral vision loss/shadow "curtain" in peripheral --> central visual fields*
Retinal detachment

18

Positive Schaffer's sign =

Seen in ___.

T/F: Normal or decreased intraocular pressure.

clumping of pigment cells in anterior vitreous

Retinal detachment

True.

19

T/F: Acidic burns is worse than alkali burns.

Tx:

False. Alkali burns are worse --> liquefactive necrosis

Tx: Immediate irrigation (Lactated Ringers, NS)
Broad spectrum abx (Moxifloxacin)

20

Infection of eyelid and periocular tissue =

T/F: Associated w/ visual changes and pain w/ ocular movement.

PRESEPTAL cellulitis

False: Associated w/ POSTseptal cellultis

21

Tx of Postseptal cellultis

Tx: IV Vancomycin, Clindamycin, Cefotaxime

22

Halo around lights, "steamy cornea", mid-dilated nonreactive pupil, eye hard to palpation seen in ___.

Acute narrow-angle closure glaucoma

23

Dx of Acute narrow-angle closure glaucoma

Tx:

Increase IOP by Tonometry (>21 mmHg)
"Cupping" of optic nerve

Tx:
1st line: Acetazolamide IV
Topical beta blocker: does NOT affect visual acuity
Miotic/cholinergics: Pilocarpine, Carbachol

Definitive tx: Peripheral iridotomy

24

Slow progressive Bilateral peripheral vision loss =

Tx:

Chronic open angle glaucoma
"Tunnel vision"

1st line: Prostaglandin analogs (Latanoprost)
Timolol

25

Viral conjunctivitis MC caused by ___ pathogen

Adenovirus

26

Keratitis (A.k.a ____)
Bacterial presents w/ ____. Tx:
HSV presents w/ ____. Tx:

Corneal ulcer/inflammation

Bacterial: Hazy cornea
Tx: FQ (Moxifloxacin)

HSV: Dendritic lesions
Tx: Trifluridine, vidarabine, Acyclovir (ointment/PO)

27

MC etiology of Optic Neuritis

PE:

Tx:

Multiple Sclerosis

= inflammation of optic nerve CN II

PE: Marcus Gunn Pupil

Tx: IV methylprednisolone --> PO steroids

28

Anterior or posterior Uveitis?
Unilateral, ocular pain, redness, photophobia

Anterior

29

Anterior or posterior Uveitis?
Blurred/decreased vision
Floaters
NO pain

Posterior

30

Ciliary injection (limbic flush), consensual photophobia, inflammatory cells and flare seen in ____

Tx:

Uveitis

Anterior: topical steroids
Posterior: systemic corticosteroids

31

Pale retina w/ cherry-red macula (red spot)
Box car appearance of veins

Central Retinal ARTERY Occlusion

32

Blood and thunder appearance
Extensive retinal hemorrhages

Central retinal VEIN occlusion

33

____ artery commonly involved in Amaurosis Fugax

External carotid artery

34

Tx of Otitis Externa

- Ciprofloxacin/dexamethasone
- Neomcin/polytrim-B/hydrocortison (do NOT use if TM perforation if suspected)

35

MC cause of acute otitis media

S. pneumo

36

If bullae on TM, suspect ___ as cause of acute otitis media.

Mycoplasma

37

Tx of Otitis Media

Drug of choice: Amoxicillin x 10-14 days
If PCN allergy: Erythromycin-Sulfisoxazole

38

Tx of mastoiditis

IV Abx (Ampicillin, Cefuroxime) w/ myringotomy
Refractory --> mastoidectomy

39

UNIlateral hearing loss is ____ until proven otherwise.

Acoustic (vestibular) CN 8 Neuroma

40

Epley Maneuver

Management of Benign Paroxysmal Positional Vertigo

= canalith repositioning

41

Vestibular neuritis + hearing loss/tinnitus =

Tx:

Labyrinthitis

Tx: corticosteroids

42

(Vertical/horizontal) nystagmus seen in central vertigo.

Vertical

43

(Vertical/horizontal) nystagmus seen in pheripheral vertigo.

Horizontal

44

Weber lateralizes to (normal/affected) ear in sensorineural loss.

Normal

SensoriNeural lateralizes to Normal ear + Normal Rhinne

45

Weber lateralizes to (normal/affected) ear in conductive loss.

Affected

46

Rinne test has AC ( > or < ) BC in normal hearing.

AC > BC

47

Rinne test has AC ( > or < ) BC in sensorineural loss.

NORMAL: AC > BC

48

Rinne test has AC ( > or < ) BC in conductive loss.

AC < BC

49

X ray view to dx acute sinusitis

Water's view

CT scan = diagnostic test of choice

50

Tx of acute sinusitis

Amoxicillin x 10-14 days**
Doxycyline
Bactrim

51

Mucormycosis

Tx:

Fungi that invades sinuses that may enter CNS
Immunocompromised pts
Affects orbits, sinuses, lungs, CNS

Tx: Amphotericin B, Posaconazole

52

____ associated w/ nasal polyps worse in AM

ALLERGIC Rhinitis

53

MC type of Rhinitis

MC infectious cause of rhinitis

MC type: Allergic = IgE mediated mast cell histamine release

Rhinovirus

54

Intranasal decongestants used > 3-5 days may cause ____

Rhinitis medicamentosa = rebound congestion

55

Sialolithiasis: Salivary stones MC in ___.

Wharton's duct (submandibular)

Stenson's duct = parotid glands

56

Oral lichen planus has increased incidence in pts/ with ___

HCV

57

Lacy leukoplakia lesions of oral mucosa

Oral lichen plancus

58

White patchy lesion that canNOT be rubbed off

Oral leukoplaia

59

T/F: 90% of oral leukoplakia are precancerous for dysplastic or evident of adenocarcinoma.

False. 90% of erythroplakia precancerous for SQUAMOUS CELL carcinoma

6% of oral keukoplakia are precancerous for squamous cell carcinoma

60

Oral hairy leukoplakia is caused by ____.
MC in pts with ____.
T/F: Can be scrapped off.

Epstein Barr Virus
HIV/immunocompromised
False. Can NOT be scrapped off

61

T/F: Oral candidiasis can be scraped off but leaves behind erythema/bleeds.

True

62

Tx of RECURRENT aphthous ulcers.

Cimetidine

63

Tx of peritonsillar abscess

Drainage + Abx (Unasyn or Clindamycin)

64

Tx of epiglottitis

IV Ceftriaxone +/- clindamycin

Rifampin for prophylaxis

65

Primary manifestation of HSV-1 in children

Acute herpetic gingivostomatitis
(6 mo-5 y/o)

66

Primary manifestation of HSV-1 in adults

Acute herpetic pharyngotonsillitis

67

Cellulitis of sublingual and sumaxillary spaces in the neck =

Presentation:

Tx:

Ludwig's angina

Swelling and erythema of upper neck and chin w/ pus on floor of mouth.

PCN + Metronidazole
Clindamycin
Ampicillin/Sulbactam (Unasyn)

68

Ramsay-Hunt Syndrome =

Caused by:

Tx:

Herpes zoster oticus = acute facial palsy + otalgia and varicella or vesicular-type lesions.
Lesions on pinna**
Facial paralysis

Herpes varicella virus

Oral steroids, antiviral, pain medication

69

Hutchinson's sign =

Suggestive of ____

Involvement of tip of nose w/ herpes virus

Involvemnt of cornea w/ herpes --> urgent ophtho referral

70

Tensilon test (A.K.A. ___) used to dx ___

edrophonium testing

Myasthenia gravis (MG)

71

Permanent decrease in visual acuity in child caused by abnormal visual exposure during maturation process =

Amblyopia

72

Hutchinson's incisors (notching of incisors) can be caused by ____.

congenital syphilis

73

"Tree branch" pattern on fluorescein stain

Herpetic infection of cornea = Herpetic keratitis

74

Otosclerosis causes (conductive/sensorineural) hearing loss

Conductive

Familial condition
Bones of middle ear soften and then harden at joints

75

Presbycusis causes (conductive/sensorineural) hearing loss

Senorineural

= age related hearing loss

76

T/F: Myringosclerosis causes conductive hearing loss.

False. Scarring of TM does NOT cause hearing loss

77

CN3 palsy is frequently associated with ____

unruptured cranial aneurysm

Ptosis, dilated pupils, lateral deviation of eye, double vision

78

Painful gingivitis and stomatitis d/t spirochetal and fusiform bacterial infection

Vincent's angina

79

Enlargement skull compresses ____ in Paget's disease.

auditory nerve (CN8) --> neural deafness

80

Medications that may worsen psoriasis

BB
Anti-malarials
Lithium

81

Condyloma lata is caused by

Treponema pallidum

=fused, weeping papules in perineum